March 24, 2012

Start time is 7:30 am

Fort Bend ISD Ken Hall Stadium

3335 Hurricane Lane, Missouri City, Texas 77459
What is the Fort Bend Education Foundation? The Foundation provides opportunities to enrich and enhance the quality of education for all Fort Bend ISD students through their grants programs. Programs include: Grants for Teachers and Schools, Grants for Experts, and Angel Gifts.

What is the Fort Bend Education Foundation? The Foundation provides opportunities to enrich and enhance Registration & Packet Pickup Information the quality of education for all Fort Bend ISD students through their grants programs. West Houston Sugar Land West U Event Day Bicycle World & Fitness Bike Route Bicycle World & Fitness Ken Hall Stadium 14536 Memorial Drive 2633 Town Center Blvd. N. 2519 Rice Blvd. 3335 Hurricane Lane 281.556.0923 281.265.3900 713.529.0140 Missouri City 77459 Tuesday, March 20th Wednesday, March 21st Thursday, March 22nd Saturday, March 24th 4:00 pm 7:00 pm 4:00 pm 7:00 pm 4:00 pm 7:00 pm 6:30 am
Registration information is also available online at www.fortbendisd.com\foundation

Schlumberger Education Expedition Registration Form Lunch included in registration. Special T-shirts for Early Registration!
Choose Your Ride Length
(circle one)

No guarantee of t-shirt after March11th

.

79 52 11 Please complete and sign one form for each rider.

Make sure your bike is ride ready We ride Rain or Shine Helmets are required No headphones allowed

___ $30 Early Registration until Feb. 5th ___ $35 Pre-Registration Feb.6th to March 4th ___ $40 Registration after March 4th ___ I cannot make the ride, but enclosed is my donation of $__________.

Rider Information: Name: Male Phone: Email: Emergency Contact:

T-Shirt Size: Women: S M L XL

Make checks payable to: Fort Bend Education Foundation 16431 Lexington Blvd Sugar Land, Texas 77479 For more information call 281.634.1110

Female Cell:

Age

Phone:
Men: S M L XL XXL

Waiver: In consideration of the acceptance of this registration, I, the undersigned, acknowledge that my participation in the Education Expedition Ride is voluntary and assume full and complete responsibility for any injury or accident, which may occur, during my participation in the Education Expedition Ride. I certify that I am physically fit and have not been informed otherwise by any physician or other health care provider. I certify that I am sufficiently experienced to ride in the Education Expedition Ride. I HEREBY RELEASE AND HOLD HARMLESS THE SPONSORS, PROMOTERS, EVENT PARTNERS, NATIONAL MULTIPLE SCLEROSIS SOCIETY, NATIONAL MULTIPLE SCLEROSIS SOCIETY LONE STAR CHAPTER AND ALL OTHER PERSONS AND ENTITIES ASSOCIATED WITH THE EVENT FROM ANY AND ALL CLAIMS, DEMANDS, OR CAUSES OF ACTION AS A RESULT OF ANY INJURY OR DAMAGE WHETHER IT IS CAUSED BY MYSELF OR BY THE NEGLIGENCE, IN WHOLE OR IN PART, OF THE SPONSORS, PROMOTERS, EVENT PARTNERS OR ANY OTHER PERSONS OR ENTITIES ASSOCIATED WITH THE EVENT. I agree to wear a helmet. I understand that a bicycle is a legal vehicle in the State of Texas and I must ride in a safe manner. I understand that the risks of a lengthy bicycle tour include, but are not limited to, head injuries, fractures, dehydration, heat exhaustion, heat stroke, heart attack, and other possible minor or major injuries. I consent to emergency medical treatment in the event of injury or illness. I consent to the use of my name and photograph in connection with the Education Expedition Ride in any form, printed or electronic. This agreement shall not be modified orally or in writing by any individual. If entrant is under 18 years of age, parent or guardian must sign entry. Children under 15 must be accompanied by an adult.

Riders Signature: ________________________________________

Date:_________________________________________

Guardians signature (if rider is under the age of eighteen): _________________________________________________________